Normal bile ducts is collected in the bladder, and then from there to the duodenum. In some pathologies it enters the stomach.
The substances formed as a result of the secretion of the cells of the liver, called bile. It is composed of bile acids, pigments, cholesterol and various phospholipids. It plays a huge role in the digestive process.
Through it into the lumen of the intestine reactions emulsification of fats, hydrolysis of lipids and the stimulation of their assimilation; the synthesis of vital triglycerides; promotes absorption of fat-soluble vitamins and calcium. In addition, bile stimulates intestinal peristalsis and activity of the pancreas; kills some types of bacteria and inactivates pepsin.
Possible causes of bile in the stomach include:
- relaxed state of the sphincter between the stomach and the duodenum;
- violation of the nervous regulation of motor activity of the digestive tract;
- transferred gastrotomy (for the ulcers);
- chronic duodenal obstruction in the stage of decompensation;
- scarring of the sphincter;
- genetic predisposition;
- the reasons for increased intra-abdominal pressure;
- chronic inflammatory diseases of the duodenum;
- malformations of the digestive system;
- condition after the removal of the gallbladder;
- treatment with drugs relaxing the smooth muscles;
- improper diet;
- tumors of the stomach and intestines.
The pressure increase in the primary divisions of the small intestine causes accumulation of bile and digestive juice of the pancreas. Accumulated secret contributes to the violation of peristalsis, duodenum increases in size, causing congestion. Do you respond to the pyloric sphincter, it relaxes, which causes the ingress of bile into the stomach.
Surgery lead to cicatricial and anatomical changes. The gatekeeper is not until the end of the closing, disturbed coordination of movements, that causes reflux of bile into the stomach. The tumor deforms the sphincter, while increasing the pressure, which eventually leads to reverse abnormal reflux of chyme.
Clinical manifestations
Yourself the symptoms of duodenogastric reflux occur rarely. Already when joining the additional pathology of the gastrointestinal tract one can observe the signs of this disease.
Patients with this disease often have:
- belching air with a sour taste;
- heartburn;
- nausea;
- vomiting;
- the presence of the taste of bitterness in the mouth;
- pain in the stomach;
- spasticskie pains in the abdomen;
- indigestion;
- bloating;
- a feeling of heaviness in the epigastrium;
- immediately after eating may be feeling the heat all over the body and sweating.
Bile entering the stomach, with frequent casting has a significant damaging effect on the mucosa. This leads to inflammatory changes, gastritis with symptoms of dyspepsia. Neurological disorders contribute to a discoordination of activity of the stomach and intestines, causing flatulence, diarrhea and abdominal pain.
To determine stomach bile using fibrogastroduodenoscopy. Signs of pathological reflux include:
- redness of the walls;
- erosion on the mucosal surface;
- swelling of the walls;
- staining a section of the stomach;
- the gaping of the pylorus;
- thickening of the folds;
- atrophic changes;
- on the surface of the intestine signs of tissue degeneration (metaplasia).
1. Using a probe to take the content for analysis, while the acidity decreases in the more alkaline side. Sometimes conduct daily pH-meter with biochemical analysis of acidic condition of gastric juice.
2. Ultrasound examination will determine the thickening of the mucous membrane and the upward movement of gas bubbles from the duodenum.
3. Fluoroscopy with barium will give you a picture of simultaneous reverse throw food remnants and bile.
4. In hospital to determine duodenogastric reflux using minimally invasive radionuclide biliary scintigraphy.
Therapies
1. To eliminate duodenogastric reflux is quite difficult. The treatment of this disease is similar to the treatment of ulcers. They are appointed agents for improving the motility of the gastrointestinal tract: Motilium, Metoclopramid (Reglan), Perinorm, Raglan, Itemid, Anatom. Motilium improves the evacuation capacity, increases the tone of the intestine and stimulates the gallbladder that is necessary for the treatment of excess bile in the stomach. The drug is available in suspension, which is very convenient for application in pediatric practice.
2. In the complex treatment of a stomach use substances that regulate the acidity of gastric juice. This group includes: Maalox, aluminium phosphate gel, Gastal, Gelusil, gaviscon. They eliminate reflux symptoms, reduced acid secretory activity of the fluid, thereby reducing stomach irritation.
3. Proton pump inhibitors – drugs that block the excessive activity of certain cells. Under the influence of drugs secretion of hydrochloric acid is greatly reduced is suppressed phase of the activity the part where the sphincter. As a result, the reflux of bile is prevented.
This group includes:
- Pantoprazole;
- Lansoprazole;
- Pariet;
- Nexium;
- Dexilant.
4. Symptoms of disorders of the liver and gallbladder will allow preparations of ursodeoxycholic acid. These chemicals treat the damaged hepatocytes and regenerate cells of the stomach, increase local immunity, improve the kinetic properties of bile, promote the lysis of gallstones. This such medicinal substances as:
- Ursofalk;
- Uradex;
- Wroclaw.
5. In the treatment of the modified membranes will help gastroprotectia. Such drugs include:
- The Venter.
- Ulgastran;
- De-Nol;
- Rebamipide.
6. Additionally for the treatment and evacuation of bile from the stomach using adsorbents:
- Smectite;
- White coal;
- Polifepan;
- Lactofiltrum.
7. For the treatment of concomitant symptoms and eliminate side effects using additional drugs: antispasmodics, vitamins and sedative substance.
How to treat stomach correctly, advise only gastroenterologist after the required surveys.
Features of the diet and folk remedies
For the treatment of pathological reflux of intestinal contents into the stomach, you must stick to the diet. It provides for the restriction:
- fat (cream, butter, lard);
- salty, spicy and sour;
- eggs;
- meats;
- spices;
- fried;
- chocolate, coffee;
- roughage;
- of carbonated beverages.
Diet implies not only the limitation of certain foods, but smaller meals. Food should be taken frequently in small portions throughout the day. Good use of lean meats and fish, cereal, stale white bread, rice, potatoes, pasta.
In addition to chemicals and a simple diet, and use folk remedies for treatment:
1. Flax seeds. Help with the reflux symptoms (heartburn, belching, bitter taste in the mouth). 1 tbsp of seeds boiled in 200 g of water for several minutes. Then left to stand for 2 hours. Infusion take 1 tbsp before meals.
2. A decoction of the roots of dandelion helps to eliminate signs of reflux. To do this, 1 tbsp. spoon roots pour a glass of boiling water. Let stand about 2 hours. Eat 4 times a day before meals.
3. Ample fluid intake will help relieve symptoms and to improve peristalsis.
Traditional medicine can eliminate inflammation, improve the motor activity of the digestive system. Treatment of reflux of bile is necessary because of its long presence in the body contributes to cancer. Constant exposure to the unusual chemical composition of the environment of the stomach stimulates the regeneration of skin cells and becomes a prerequisite for the development of ulcers, and then the tumor. Adhering to a proper diet and the recommended therapy, you can achieve positive results.
